AB1567-HPR SOCIAL WORKERS: DESCRIBING SOCIOECONOMIC CHARACTERISTICS DURING PRENATAL CARE IN PATIENTS FROM A PREGNANCY AND AUTOIMMUNE RHEUMATIC DISEASES CLINIC.
Authors: M. E. Corral Trujillo, F. R. Arevalo Nieto, L. G. Espinosa Banuelos, C. M. Skinner Taylor, L. Pérez Barbosa, A. Y. Lujano Negrete, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2022)

Background Social workers (SW) interventions are fundamental in health care; the main objective is to identify and mitigate social determinants of the patient’s health. The socioeconomic study (SES) is the core assessment of SW; it analyzes the demographic structure and population dynamics. Objectives Describe the sociodemographic and social security characteristics in pregnant patients with autoimmune rheumatic diseases. Methods A cross-sectional and retrospective study was conducted in a pregnancy and rheumatic diseases outpatient clinic from the university hospital in Monterrey, México. The data from the SES database was collected. The sociodemographic information, family’s monthly income and expenses, expenditures related to healthcare, type of social security, family nucleus (FN) and socioeconomic level (SL) were analized. The rheumatic diagnosis was retrieved from the medical records. The SL is classified in 7 levels (according to the score obtained in the SES); each level represents a percentage of the total cost of the healthcare received. Level 1 to 3 correspond to 0 - 28% percentage while levels 4 to 7 go from 53 to 100% of total payment that is due. To evaluate the health expenditure, the monthly limit expenditure per Mexican family is 98.39 dollars (the limit expenditure was taken from the Organization for Economic Co-operation and Development “OECD” 2019 report). For statistical analysis, the sociodemographic and clinical characteristics of the sample are presented as frequencies and percentages. Results From 2019 to 2021, 54 patients were interviewed. The mean age was 28.46 years(SD=6.69). The rheumatic diagnoses can be found in Table 1. The most common occupation was unemployment(n=34, 62.96%) and only completed basic levels of education(n=37,68.51%). Table 1. Sociodemographic characteristics n=54 Demographic Data Age, mean(SD ) 28.46(6.69) Occupation, n(% ) Unemployed 34(62.96) Employed 17(31.48) Self-Employed 3(5.55) Marital Status, n(% ) Married/Cohabitating 38(70.37) Single 16(29.62) Level of Education, n(% ) Basic education 37(68.51) Higher education 17(31.48) Family Structure Family members, n(% ) 0-5 36(66.66) 6-11 18(33.32) Number of children, n(% ) 1 36(66.66) 2 13(24.07) 3 5(9.25) Family Nucleus, n(% ) Nuclear 27(50) Multi-nuclear 26(48.14) Extended 1(1.85) Rheumatic Disease, n (% ) Rheumatoid arthritis 29(53.7) Lupus 9(16.66) Antiphospholipid syndrome 8(14.81) Sjögren syndrome 1(1.85) Health Expenditure, n(% ) Active health insurance None 39(72.22) Public health services (governmental and state workers) 8(14.81) Private health insurance 7(12.96) Average monthly family income (USD ) $614.23 Average monthly health expenditure (USD ) $105.71 Percentage of expenses in patient’s health 16.21% SD:Standard deviation The most frequent SL was level 3 (46.29%) and the predominant FN was the nuclear family (50%) (couple and their dependent children). Most of them were not under any health coverage(n=39, 72.22%). The average family income was $614.23 USD and the average health expenditure was 105.71 USD; which represents 16.21% of the family income (per month). Conclusion SW play a key role understanding basic needs and identifying health determinants that decreases the odds of access of healthcare. Women with autoimmune rheumatic diseases have an important burden of the main determinants of health like low income, unemployment, basic education, and poor health coverage. In addition, the average health expenditure is higher than the recommended by OECD. Different strategies are needed for childbearing age patients with rheumatic diseases to decrease the impact of health determinants. References [1]Sagrario, M. et al. (2006). El apoyo del trabajador social al paciente reumático. Epica, 28 (6),6-8. [2]Silva, M. et al. (2015). Validez y Confiabilidad del Estudio Socioeconómico. Dgapa, UNAM. ISBN 978-607-02-7296-7 [3]OECD (2019), Health at a Glance 2019: OECD Indicators , OECD Publishing. DOI: 10.1787/4dd50c09-en Disclosure of Interests None declared